Volume 12, Issue 1 (3-2024)                   JoMMID 2024, 12(1): 42-49 | Back to browse issues page

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Nair S, Oommen S, Pai V. Assessing the Genetic Diversity of Mycobacterium tuberculosis Strains in Kerala, India: A Comprehensive Study. JoMMID 2024; 12 (1) :42-49
URL: http://jommid.pasteur.ac.ir/article-1-562-en.html
Department of Microbiology, Pushpagiri Institute of Medical Sciences and Research Centre, Tiruvalla, Kerala, India
Abstract:   (178 Views)
Introduction: Understanding the epidemiological and clinical characteristics of different tuberculosis strains is crucial for developing improved diagnostic tools, drugs, and vaccines for tuberculosis management. This study aimed to investigate the molecular epidemiology of Mycobacterium tuberculosis using spoligotyping, a widely used molecular typing method, to understand the genetic diversity and transmission dynamics of M. tuberculosis, on isolates obtained from patients with pulmonary tuberculosis in central Kerala. Methods: In a prospective study at a tertiary care hospital, 404 respiratory specimens from patients with symptoms suggestive of TB were collected. Specimens underwent Ziehl-Neelsen staining, culture in liquid (BD BACTEC™ MGIT™) and solid (Lowenstein-Jensen) media, and standard drug susceptibility testing with the MGIT system. Molecular analysis involved conventional PCR amplification of genomic DNA to generate sufficient genetic material for analysis, using species-specific and primers targeting the direct repeat region, followed by spoligotyping to assess the genetic diversity of the M. tuberculosis strains. Results: Out of 404 samples from individuals with suspected pulmonary TB, Mycobacteria were cultured from 48 [11.9%] of the samples. Amongst the 48 culture-positive M. tuberculosis isolates, 20 (41.66%) were sensitive to all five first-line anti-TB drugs, and 3 (6.2%) were resistant to all five drugs. Spoligotyping of the 47 isolates showed that 36.1% [n=17] of the isolates belonged to the M. tuberculosis EAI3 (East African-Indian) family, followed by 27.6% (n=13) M. tuberculosis EAI5 and 21.2% (n=10) M. tuberculosis CAS (Central Asia). Other families observed in this study, although less prevalent, were M. tuberculosis Beijing, 8.5% (n=4), family 33, 4.3% (n=2), and Mycobacterium bovis-BCG family, 2.1% (n=1). Conclusion: This study explored the genetic diversity and distribution of circulating M. tuberculosis strains in central Kerala. Genotyping M. tuberculosis strains provides valuable insights into TB transmission and progression, which can inform the development of effective public health control strategies.
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Type of Study: Original article | Subject: Epidemiologic studies including microbial genotyping, phenotyping and serotyping
Received: 2023/06/9 | Accepted: 2024/05/21 | Published: 2024/06/8

1. World Health Organization. Global TB report [Internet]. 2018. Available from: WHO/CDS/TB/2018.20
2. Khayat M, Fan H VY. COVID-19 promoting the development of active tuberculosis in a patient with latent tuberculosis infection: a case report. Respir Med Case Rep. 2021; 32: 101344. [DOI:10.1016/j.rmcr.2021.101344] [PMID] []
3. Division CT. India TB Report National Tuberculosis Elimination Programme Annual Report. 2020.
4. Vluggen C, Soetaert K, Groenen G, Wanlin M, Spitaels M, De Oñate WA, et al. Molecular epidemiology of Mycobacterium tuberculosis complex in Brussels, 2010-2013. PLoS One. 2017; 12 (2): 2010-3. [DOI:10.1371/journal.pone.0172554] [PMID] []
5. Chawla K, Kumar A, Shenoy VP, Chauhan DS, Sharma P. Genetic diversity of Mycobacterium tuberculosis in south coastal Karnataka, India, using spoligotyping. Indian J Med Res. 2018; 147 (3): 278-86. [DOI:10.4103/ijmr.IJMR_2026_16] [PMID] []
6. Prasad R, Gupta N, Banka A. Multidrug‑resistant tuberculosis/rifampicin‑resistant tuberculosis : Principles of management. 2018;78-81. [DOI:10.4103/lungindia.lungindia_98_17] [PMID] []
7. Behera D BR. COVID-19 & the National Tuberculosis Elimination Programme of India. Indian J Med Res. 153 (5): 533-6. [DOI:10.4103/ijmr.IJMR_2763_20] [PMID] []
8. Gupta R, Singh R, Prakash R, Jain S, Tiwari PK. Journal of Infection and Public Health Spoligotyping , phenotypic and genotypic characterization of katG , rpoB gene of M . tuberculosis isolates from Sahariya tribe of Madhya Pradesh India. J Infect Public Health [Internet]. 2019; 12 (3): 395-402. [DOI:10.1016/j.jiph.2018.12.009] [PMID]
9. Ravansalar H, Tadayon K, Ghazvini K. Molecular typing methods used in studies of mycobacterium tuberculosis in Iran: A systematic review. Iran J Microbiol. 2016; 8 (5): 338-46.
10. Kamerbeek J, Schouls L, Kolk A, Van Agterveld M, Van Soolingen D, Kuijper S, et al. Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology. J Clin Microbiol. 1997; 35 (4): 907-14. [DOI:10.1128/jcm.35.4.907-914.1997] [PMID] []
11. Shanmugam S, Selvakumar N NS. Drug resistance among different genotypes of Mycobacterium tuberculosis isolated from patients from Tiruvallur, South India. Infect Genet Evol. 2011; 11 (5): 980-6. [DOI:10.1016/j.meegid.2011.03.011] [PMID]
12. P. M. Groenen, A. E. Bunschoten, D. van Soolingen and JDA van E. Nature of DNA polymorphism in the direct repeat cluster of Mycobacterium tuberculosis; application for strain differentiation by a novel typing method. Mol Microbiol. 1993; 10 (5): 1057-65. [DOI:10.1111/j.1365-2958.1993.tb00976.x] [PMID]
13. Van Embden JDA, Van Gorkom T, Kremer K, Jansen R, Van Der Zeijst BAM, Schouls LM. Genetic variation and evolutionary origin of the direct repeat locus of Mycobacterium tuberculosis complex bacteria. J Bacteriol. 2000; 182 (9): 2393-401. [DOI:10.1128/JB.182.9.2393-2401.2000] [PMID] []
14. Gullans C R., Sr In: Isenberg H D editor. C microbiology procedures handbook. Digestion-decontamination procedures. 1992. 3.4.1-3.4.14.
15. Siddiqi SH, Rüsch-Gerdes S. For BACTECTM MGIT 960TM TB System (Also applicable for Manual MGIT). Found Innov New Diagnostics. 2006.
16. Christophe Demay, Benjamin Liens, Thomas Burguière,
17. Véronique Hill, David Couvin, Julie Millet, et al. SITVITWEB - A publicly available international multimarker database for studying Mycobacterium tuberculosis genetic diversity and molecular epidemiology. Infect Genet Evol. 2012; 12 (4): 755-66. [DOI:10.1016/j.meegid.2012.02.004] [PMID]
18. Sivakumar S, Chandramohan Y, Kathamuthu GR, Sekar G, Kandhasamy D, Padmanaban V, et al. The recent trend in mycobacterial strain diversity among extra pulmonary lymph node tuberculosis and their association with drug resistance and the host immunological response in South India. BMC Infect Dis. 2020; 20 (1): 849. [DOI:10.1186/s12879-020-05597-0] [PMID] []
19. Kandhakumari G, Stephen S, Sivakumar S NS. Spoligotype patterns of Mycobacterium tuberculosis isolated from extra pulmonary tuberculosis patients in Puducherry, India. Indian J Med Microbiol. 2015; 33 (2): 267-70. [DOI:10.4103/0255-0857.154871] [PMID]
20. Gori A, Bandera A, Marchetti G, Esposti A, Catozzi L, Nardi G, et al. Spoligotyping and Mycobacterium tuberculosis. Emerg Infect Dis. 2005; 11 (8): 1242-8. [DOI:10.3201/eid1108.040982] [PMID] []
21. Comas I, Coscolla M, Luo T et al. Out-of-Africa migration and neolithic coexpansion of Mycobacterium tuberculosis with modern humans. Nat Genet. 2013; 45 (1): 1176-82. [DOI:10.1038/ng.2744] [PMID] []
22. Merker M, Blin C, Mona S, Duforet-Frebourg N, Lecher S, Willery E, et al. Evolutionary history and global spread of the Mycobacterium tuberculosis Beijing lineage. Nat Genet. 2015; 47 (3): 242-9. [DOI:10.1038/ng.3195] [PMID] []
23. Reed MB, Pichler VK, McIntosh F, Mattia A, Fallow A, Masala S, et al. Major Mycobacterium tuberculosis lineages associate with patient country of origin. J Clin Microbiol. 2009; 47 (4): 1119-28. [DOI:10.1128/JCM.02142-08] [PMID] []
24. Coscolla M GS. Does M. tuberculosis genomic diversity explain disease diversity? Drug Discov Today Dis Mech. 2010; 7 (1): 43-59. [DOI:10.1016/j.ddmec.2010.09.004] [PMID] []
25. Narayanan S, Gagneux S, Hari L, Tsolaki AG RS, Narayanan PR, Small PM, et al. Genomic interrogation of ancestral Mycobacterium tuberculosis from south India. Infect Genet Evol. 2008; 8 (4): 474-83. [DOI:10.1016/j.meegid.2007.09.007] [PMID] []
26. Thomas SK, Iravatham CC, Moni BH, Kumar A AB, Majid M, Priyadarshini Y, et al. Modern and ancestral genotypes of Mycobacterium tuberculosis from Andhra Pradesh, India. PLoS One. 2011; 6 (11): 275-84. [DOI:10.1371/journal.pone.0027584] [PMID] []
27. Singh J, Sankar MM, Kumar P, Couvin D, Rastogi N SSIT, Network. D. Genetic diversity and drug susceptibility profile of Mycobacterium tuberculosis isolated from different regions of India. J Infect. 2015; 71 (2): 207-19. [DOI:10.1016/j.jinf.2015.04.028] [PMID]
28. Gagneux S, DeRiemer K, Van T, Kato-Maeda M, de Jong BC, Narayanan S, et al. Variable host-pathogen compatibility in Mycobacterium tuberculosis. Proc Natl Acad Sci USA. 2005; 103 (28): 2869-73. [DOI:10.1073/pnas.0511240103] [PMID] []
29. Liu H, Prugnolle F, Manica A BF. A geographically explicit genetic model of worldwide human-settlement history. Am J Hum Genet. 2006; 79 (2): 230-7. [DOI:10.1086/505436] [PMID] []
30. Macaulay V, Hill C, Achilli A, Rengo C, Clarke D, Meehan W et al. Single, rapid coastal settlement of Asia revealed by analysis of complete mitochondrial genomes. Science. 2005; 308 (5724): 1034-6. [DOI:10.1126/science.1109792] [PMID]
31. Vijaya-Bhanu N, van Soolingen D, van Embden JDA, Dar L P, RM SP. Predominance of a novel Mycobacterium tuberculosis genotype in the Delhi region of India. Tuberculosis. 2002; 82 (2/3): 105-12. [DOI:10.1054/tube.2002.0332] [PMID]
32. Kulkarni S, Sola C, Filliol I, Rastogi N KG. Spoligotyping of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mumbai, India. Res Microbiol. 2005; 156 (4): 588-96. [DOI:10.1016/j.resmic.2005.01.005] [PMID]
33. Gascoyne-Binzi DM, Barlow RE, Essex A, Gelletlie R, Khan MA H, S, Collyns TA, Frizzell R HP. Predominant VNTR family of strains of Mycobacterium tuberculosis isolated from South Asian patients. Int J Tuberc Lung Dis. 2002; 6 (6): 492-6. [DOI:10.5588/09640569512995] [PMID]
34. Farnia P, Mohammadi F, Masjedi MR, Varnerot A, Zarifi AZ T, J, Douraghei M, et al. Evaluation of tuberculosis transmission in Tehran: using RFLP and spoligotyping methods. J Infect. 2004; 49 (2): 94-101. [DOI:10.1016/j.jinf.2003.11.015] [PMID]
35. Sola C, Filliol I, Guttierez Mokrousov I, Vincent V RN. Spoligotype database of Mycobacterium tuberculosis: Biogeographical distribution of shared types and epidemiological and phylogenetic perspectives. Emerg Inf Dis. 2001; 7 (3): 390-6. [DOI:10.3201/10.3201/eid0703.0107304]
36. Arora J, Singh UB, Suresh N, Rana T PC, Kaushik A et al. Characterization of predominant Mycobacterium tuberculosis strains from different subpopulations of India. Infect Genet Evol. 2009; 9 (5): 832-9. [DOI:10.1016/j.meegid.2009.05.008] [PMID]
37. López B, Aguilar D, Orozco H, Burger M, Espitia C, Ritacco V, et al. A marked difference in pathogenesis and immune response induced by different Mycobacterium tuberculosis genotypes. Clin Exp Immunol. 2003; 133 (1): 30-7. [DOI:10.1046/j.1365-2249.2003.02171.x] [PMID] []

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.